Individual provider Active NPI

Kelsey E Davidson, M.D.

  • Orthopaedic Surgery Physician
  • Chicago, IL
National Provider Identifier
1366732364
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036143920 Issued in IL
Practice address
2211 N Oak Park Ave
Chicago, IL 60707-3351
Phone
(773) 385-5463
NPI assigned
Apr 11, 2011
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036143920 IL Primary

Addresses

Primary practice location

2211 N Oak Park Ave
Chicago, IL 60707-3351

Mailing address

Shriners Hospitals for Children Chicago
2211 North Oak Park Ave
Chicago, IL 60707-3351

Other practice location 1

5445 Meridian Marks Rd
Orthopedic Surgery, Suite 250
Atlanta, GA 30342-4763
Phone (678) 686-6818

Other practice location 2

1801 W Taylor St
Chicago, IL 60612-4795
Phone (312) 996-7416

Other identifiers 1

IdentifierTypeStateIssuer
1366732364MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210325000755 IL Practitioner - Orthopedic Surgery 9133424948 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036143920ILMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Board of Trustees of the University of Illinois CurrentSince May 6, 2022 Accepting new patients
Shriners Hospitals for Children CurrentSince Dec 23, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois Orthopaedic Surgery CurrentSince May 6, 2022 Accepting new patients
Shriners Hospitals for Children CurrentSince Dec 23, 2020 Accepting new patients
Cook County Current Accepting new patients
Cook County CurrentSince Apr 22, 2021 Accepting new patients
Cook County CurrentSince Apr 22, 2021 Accepting new patients
Shriners Hospitals for Children Current Accepting new patients
Gibson Community Hospital Association Past Accepting new patients
Shriners Hospitals for Children Past Accepting new patients

Locations

1801 W Taylor St
Chicago, IL 60612
Phone (312) 355-1700

1801 W Taylor St
#2A
Chicago, IL 60612
Phone (312) 355-3060

1901 W Harrison St
Chicago, IL 60612
Phone (312) 864-5100

2211 N Oak Park Ave
Chicago, IL 60707
Phone (773) 385-5463

500 E 51st St
Chicago, IL 60615
Phone (312) 572-2000

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

901 S Wolcott Ave
Chicago, IL 60612
Phone (312) 996-3470

Interoperability endpoints

  • Direct secure messaging: kdavidson120331@uihealth.direct-ci.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1366732364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SHRINERS HOSPITALS FOR CHILDREN CHICAGO",
            "address_2": "2211 NORTH OAK PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607073351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 N OAK PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "607073351",
            "telephone_number": "773-385-5463"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5445 Meridian Marks Rd",
            "address_2": "Orthopedic Surgery, Suite 250",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303424763",
            "country_code": "US",
            "telephone_number": "678-686-6818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606124795",
            "country_code": "US",
            "telephone_number": "312-996-7416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "KELSEY",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-11",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036143920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366732364",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.